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Absolute volumetric coronary blood flow measurement with digital subtraction angiography
1Department of Radiological Sciences University of California, Irvine 92697, USA.
Insights
This study introduces a new method for measuring volumetric coronary blood flow using digital subtraction angiography (DSA) in swine models. This technique accurately assesses coronary artery stenosis, improving diagnostic capabilities.
Area of Science:
- Cardiovascular imaging
- Interventional cardiology
- Biomedical engineering
Background:
- Visual interpretation of coronary arteriograms has limitations in assessing stenosis severity.
- Physiologic assessment of coronary artery stenosis is needed during routine procedures.
- Volumetric coronary blood flow analysis can aid in determining functional significance of obstructions.
Purpose of the Study:
- To investigate a volumetric coronary blood flow measurement technique using phase-matched temporal subtraction images.
- To assess the functional significance of coronary artery stenosis.
- To develop an automatic estimation technique for iodine calibration slope.
Main Methods:
- Utilized a swine animal model with instrumented left anterior descending (LAD) coronary artery.
- Employed ultrasound flow probes and vascular occluders to induce stenosis.
- Performed contrast material injections during image acquisition for phase-matched temporal subtraction (DSA) imaging.
- Measured volumetric coronary blood flow in the LAD and investigated automatic iodine calibration.
Main Results:
- Demonstrated excellent correlation between volumetric coronary blood flow (FPA) and ultrasound flow (US) measurements (FPA = 0.92US + 1.42 ml/min, r = 0.99).
- The automatic iodine calibration technique proved to be highly accurate.
- Accurate volumetric coronary blood flow measurements were achievable before contrast injection significantly altered flow dynamics.
Conclusions:
- Volumetric coronary blood flow measurement using DSA is a viable and accurate method.
- This technique can reliably assess coronary artery stenosis severity.
- The findings support the use of this method for improved functional assessment in routine coronary angiography.
Abstract:
The problems associated with visual interpretation of coronary arteriograms have been well-documented. There is a need for more physiologic means of assessing coronary artery stenosis during routine coronary arteriography. Volumetric coronary blood flow assessed as a function of time can be a valuable aid in the analysis of functional significance of arterial obstruction. A volumetric coronary blood flow measurement technique was investigated in a swine animal model using phase matched temporal subtraction images. The left anterior descending (LAD) coronary artery of swine animal models were instrumented with an ultrasound flow probe (US) and a vascular occluder producing stenosis. Contrast material injections (2-4 ml/sec for 3 sec) were made into the left coronary ostium during image acquisition. Phase-matched temporal subtraction (DSA) images were used to measure volumetric coronary blood flow in the LAD. In addition, a technique for automatic estimation of iodine calibration slope was also investigated. In 49 independent comparisons, the mean coronary blood flow (FPA) correlated extremely well with the mean US flow (FPA = 0.92US + 1.42 ml/min, r = 0.99, standard error of estimate (SEE) = 4.32 ml/min). Further more, the automatic iodine calibration technique was shown to be very accurate. In conclusion, accurate volumetric coronary blood flow measurements can be made before the onset of significant changes in coronary blood flow due to contrast injection.